other DPD Flashcards
Causes of haemolytic anaemia
Genetic: hereditary spherocytosis (RBC membrane defect), G6PD deficiency, haemoglobulinopathies
Acquired: drugs, AI, MAHA, infection
Heinz bodies cells on blood films
G6PD deficiency haemolytic anaemia
Aplastic anaemia common cause
Parovirus B19
Haemophilia (bleeding into joints) have which abnormal bleeding times
Increased APTT only
Haemophilia A
Factor 8 deficiency
Heamopihlia B
Factor 9 deficiency
Anti-thyroid drugs examples
Carbimazole
Propylthiouracil (can be used in pregnancy)
Started at high dose and then decreased. Stopped when patients develop neutropenic fevers and sore throats
Clinical features specific to Graves’ in hyperthyroidism
Exopthalmos (and proptosis due to anti-TSHr antibodies)
Thyroid acropachy
Pretibial myoxedema
Infective endocarditis can result in
splenomegaly
Reiter’s syndrome
Urethritis
Conjunctivitis
Reactive arthritis
This is a precursor of joint problems e.g. ankylosing spondylitis.
Campbell de Morgan spots
normal and benign
no pathology known
Viral hepatitis will show which LFT to be the highest?
ALT
Hepatic cirrhosis will show which LFT to be the highest?
AST
Spider naevi appear in anatomical distribution of SVC and above the nipple line. they suggest…
Chronic liver disease
When they are pressed in the centre, they blanch
RDW = red cell distribution width i.e. the spread of MCV in blood film. It is increased in….
mixed anaemia picture
i.e. IDA together with pernicious anaemia/ coeliac disease (-> IDA + vitB12 def)
osmolality equation
2(Na+K) + urea + glucose
anion gap equation
Na + K - Cl - HCO3
If anion gap >18MM, there is met acidosis
causes of macrocytic anaemia
alcohol myelodysplasia hypothyroidism liver disease folate/vitB12 deficiency
Prussian blue iron stain +ve
haemochromatosis
Amyloidosis histochemical stains
Congo red +ve (glomerulus)
Apple green birefringence
Cytokeratin immunohistochemical stains (epithelial marker) distinguishes between….
carcinomas and lymphomas
CD45+ve
Lymphoma
CK20+ve
Adenocarcinoma e.g. colorectal cancer
Lower GI tumours marker
Carcinogenic embryonic antigen (CEA)
present in other: stomach lung breast pancreas cancer, infections, hepatitis, IBD
Pancreatic cancer tumour marker
Ca19-9
present in other: GI tumours, pancreatitis, cirrhosis
Breast cancer tumour markers
Ca15-3
Now Ca27-29 is better
Ovarian cancer tumour marker
Ca-125
present in other: ascites, menstruation, pregnancy
AFP is raised in
HCC
Testicular cancer (also b-hCG)
Pregnancy (also b-hCG)
Disseminated Intravascular Coagulation (DIC) results in
Low platelets +fibrinogen
High PT/APTT
High D-dimer/ fibrin degradation products
-> microangiopathic haemolytic anaemia
Almost all causes of hypoNa+ are due to
Increased vasopressin
Rarer causes: excess water intake, Na+ free irrigation solutions (used in TURP)
Causes of cavitating lung lesions
Infection (TB, staph, Klebsiella esp in alcoholics)
Inflammation (WG, RhA)
Infarction (PE)
Malignancy
30 year old man presents with recurrent GI and nose bleeds. Facial examination shows mucosal membrane petechiae. What is the likely diagnosis?
Hereditary haemorrhagic telangiectasia
Autosomal dominant
Abnormal BVs in skin, mucous membranes, lungs, liver, brain
Eosinophils are present in…
Allergic reactions (asthma, contact dermatitis)
Parasitic infection
Tumours (Hodgkin’s)
Mast cells are present in…
Allergic reactions
Type 1 hypersensitivity
Macrophages are present in…
Late acute inflammation
Chronic inflammation - including granulomas
(i.e. at the end of acute and at the start of chronic inflammation)
TB histology shows
Caseating granulomas
Epithelial macrophages
(Ziehl neelson stain shows acid fast bacilli)
What cell type do these tumours belong? Carcinomas Sarcomas Lymphoma Melanoma
Carcinomas - epithelial cells
Sarcomas - native tissue
Lymphomas - lymph cells
Melanoma - skin cells
Keratin production
Intercellular bridges
present in which type of carcinoma?
Squamous cell carcinoma
Mucin production
Glands
present in which type of carcinoma?
Adenocarcinomas
Sites of origin of squamous cancers
Skin Head and neck Oesophagus Anus Cervix Vagina
Sites of origin of adenocarcinomas
Lung Breast Stomach Colon Pancreas
Giant multinuclear cells present in…
herpes simplex virus
What is monitored in HIV patients?
HIV RNA levels (viral load) and CD4 levels
vWF disease mainly presents as
epistaxis (nosebleeds)
